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Biomedical subjects

M Slomowitz

Publications and source records attributed to M Slomowitz.

5 recordsLinked to original sources

Characteristics of short-stay admissions to a psychiatric inpatient service.

Since the rapid expansion of managed care coupled with dramatic reductions in lengths of inpatient stay, there is widespread concern that the emphasis on cost containment is eclipsing attention to patient care. The present study was undertaken to evaluate speculations that the majority of short-stay (less than 48 hours) admissions to a psychiatric inpatient service at a large teaching hospital in the midwestern United States consisted of public pay patients who were rapidly transferred to area state hospitals. Using two cases mix measures, severity of illness and changes in acuity and clinical outcomes of a sample of short-stay (n = 77) and longer stay (n = 145) admissions were compared. Short-stay admissions, although similar to longer stay patients in terms of demographics, Axis I diagnosis, payer status, and appropriateness of admission, are clinically distinct. The use of nonhospital alternatives in treating a subsample of suicidal patients and the implications for improved mental health services delivery are discussed.

Adult↗

Use of tricyclic antidepressants in recipients of heart transplants.

Cardiac transplantation has become an accepted treatment for certain endstage cardiac disease patients. Depression and significant psychosocial stress among heart transplant recipients are not uncommon, but published reports about the use of antidepressants in these persons are very rare. The authors of this study report on a group of nine heart transplant recipients treated with antidepressant medicines. Seven patients achieved clinical remissions of their depression, and only two were unable to tolerate the noncardiac side effects of the medication. Indicators of autonomic, electrocardiographic, and hemodynamic functions showed no adverse effects. Although the study is based on a small sample, it appears that tricyclic antidepressants are safe and effective in heart transplant recipients.

Adaptation, Psychological↗

Determinants of emergency psychiatric admission for adolescents and adults.

The authors compared correlates of admission for 100 patients older than 18 years and 100 patients younger than 18 evaluated in a psychiatric emergency service. Stepwise linear logistic regression analysis identified a combination of variables that best predicted the odds of hospitalization for each group. For adolescents, these variables, in order of importance, were suicidal tendencies, physical abuse, a primary diagnosis of schizophrenia, age, and number of suicide attempts. For adults, the variables were delusions, aggressive behavior, suicidal tendencies, and a primary diagnosis of schizophrenia or affective disorder. The authors discuss the implications of these findings for acute psychiatric treatment of adolescents.

Adolescent↗

A retrospective study of adolescents' visits to a general hospital psychiatric emergency service.

Characteristics of 100 visits by adolescents (less than 18 years old) to a psychiatric emergency service were examined and compared with those of 100 visits by adults. Adolescents were less likely than adults to receive diagnoses of psychosis and personality disorder but more likely to receive diagnoses of adjustment and conduct disorders, were less likely to have had previous psychiatric treatment but equally likely (40%) to be in current treatment, and required more time to evaluate. Self-destructive ideation or behavior was present in 40% of the adolescents. Nearly all visits were judged to have represented genuine emergencies.

Adjustment Disorders↗